肾小球C4d沉积在慢性肾病早期诊断及预后的价值分析

目的 分析肾小球沉积C4d在慢性肾病中的价值,为临床提供可靠依据。方法 本次研究选自2014年1月～2017年1月医院肾内科肾脏病理检验患者194例，其中慢性肾脏病86例，急性肾损伤性疾病108例，均采用免疫组织化学检验肾小球C4d，进行沉积分型，慢性肾脏病对象划分为有效组（8周内随访蛋白尿得到控制）、对照组。对比慢性肾脏病、急性肾损伤患者肾小球C4d沉积情况，分析慢性肾脏病在C4d沉积表达中是否存在独立作用。分析肾小球C4d沉积是否在慢性病治疗中起到作用。结果 慢性肾脏病肾小球C4d阳性率、毛细血管袢区沉积伴系膜区沉积比重高于急性肾脏病对象，差异有统计学意义（P＜0.05）。肾小球毛细血管袢区C4d沉积成为慢性肾脏病疾病未获得控制的独立影响因素（P＜0.05）。结论 肾小球C4d沉积在早期诊断及判断预后具有价值，肾小球C4d毛细血管袢区沉积伴系膜区沉积慢性肾脏病风险较高，同时在疗效预测上有更高的价值。

Value of Glomerular C4d Deposition in Early Diagnosis and Prognosis of Chronic Kidney Disease

Abstract:Objective To analyze the value of glomerular deposition C4d in chronic nephropathy.Methods From January 2014 to January 2017,194 cases of renal pathology were selected,including 86 cases of chronic kidney disease and 108 cases of acute renal injury disease.Glomerular C4d was detected by immunohistochemistry to classify sediments.Subjects with chronic kidney disease were divided into effective groups(control of proteinuria within 8 weeks)and controls.To compare the glomerular C4d deposition in patients with chronic kidney disease and acute kidney injury,and to analyze the independent role of chronic kidney disease in the expression of C4d deposits.Analysis of glomerular C4d deposition plays a role in the treatment of chronic diseases.Results The positive rate of glomerular C4d in chronic kidney disease,deposition in the capillary region,and deposition in the mesangial area were higher than those in acute kidney disease,and the difference was statistically significant(P<0.05).The deposition of C4d in the glomerular capillary loop area was an independent factor that did not control chronic kidney disease(P<0.05).Conclusion The glomerular C4d deposition is valuable in early diagnosis and prognosis.Glomerular C4d in the capillaries of the glomerulus is associated with a higher risk of deposition of chronic kidney disease in the mesangial area,and has a higher value in predicting the efficacy.